With health care funders' increasing approval of telehealth service as an emergency measure to provide continuity of care during the COVID-19 crisis, practicing behavior analysts have an unprecedented opportunity to demonstrate that essential, medically necessary behavior-analytic services can be provided via telehealth in a manner that maintains treatment integrity and produces meaningful client outcomes. This telehealth treatment selection guide was designed to assist practicing behavior analysts in determining an appropriate protocol for the delivery of 1:1 telehealth service (i.e., a behavior technician providing instruction directly to a client, with or without the assistance of the client's caregiver, through videoconferencing). This tool aims to help behavior analysts make thoughtful clinical decisions to maintain continuity of care for the vulnerable population with autism spectrum disorders, while adhering to safety measures that provide protection to society. Keywords COVID-19. social distancing. telehealth. treatment integrity At the time of publication of this article, a global pandemic (COVID-19) has necessitated drastic changes to societal structures the world over: Entire states, provinces, and even countries have been placed under government orders for citizens to remain at home, allowing only essential services to continue. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have released guidance on community mitigation strategies (CDC, n.d., WHO, 2020); limiting close social contact (i.e., social distancing) has previously been identified as critical to slowing the spread of pandemics and is ultimately expected to save countless lives (CDC, 2017). In the United States, a national state of

With healthcare funders increasing approval of telehealth service as an emergency measure to provide continuity of care during the COVID-19 crisis, practicing behavior analysts have an unprecedented opportunity to demonstrate that essential, medically necessary behavior analytic services can be provided via telehealth in a manner that maintains treatment integrity and produces meaningful client outcomes. This telehealth treatment selection guide was designed to assist practicing behavior analysts in determining an appropriate protocol for delivery of 1:1 telehealth service (i.e., a behavior technician providing instruction directly to a client, with or without assistance by the client’s caregiver, through video conferencing). This tool aims to help behavior analysts make thoughtful clinical decisions to maintain continuity of care for the vulnerable ASD population, while adhering to safety measures providing protection to society.

Clients of applied behavior analysis (ABA), specifically Black, Indigenous, and People of Color (BIPOC) receiving treatment for Autism Spectrum Disorder (ASD), regularly experience the effects of systemic racism via biases in the healthcare system. Applied behavior analysis (ABA) as a science offers the necessary tools to support immediate, concrete actions to bring about social justice. This paper offers a brief conceptual framework of critical race theory (CRT); cultural competence, responsiveness, and humility; and social justice concepts. Applications to healthcare, including systemic racism and implicit bias, are offered along with points of personal reflection. These conceptual frameworks are synthesized in support of a cultural responsiveness curriculum, rooted in the tenets of CRT and cultural competence trainings in neighboring disciplines, that the authors offer as an immediate, actionable step that Board Certified Behavior Analysts (BCBAs) can take today to broaden their perspective and proficiency. The prospective benefits of this work include effecting change in the access to and outcomes of behavior analytic services, particularly for the treatment of Autism Spectrum Disorder (ASD) in marginalized communities.

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During the COVID-19 pandemic, applied behavior analysis services for many autistic individuals were transitioned to telehealth. The current study assessed caregiver-reported quality of life (QoL) and social validity for families of autistic children receiving only telehealth services (n = 96) or a combination of telehealth and in-person services (n = 173).Barriers to the telehealth experience were analyzed via an ANOVA, and the impact of funding source was analyzed using an independent samples t-test. Caregivers reported benefit across QoL and social validity items, with scores ranging from 3.31 to 4.44 (1 = least benefit, 5 = most benefit). While many caregivers reported no barriers regarding technology (44.61%), childcare (69.52%), and employment (64.68%), the presence of those barriers significantly impacted QoL and social validity scores. Funding source was not found to have a significant impact. Overall, caregivers found value in their child's telehealth services. Clinicians have an obligation to mitigate barriers to ensure the success of the intervention.